Is it always a good idea to not contradict a person with dementia?
I recently saw a list of the three "golden rules of dementia care." They are:
1. Don’t ask direct questions.
2. Listen and learn from the person living with dementia.
3. Don’t contradict.
I have no objection to the second one, but I'm curious how others are handling the other two. I can see following all three when a person is in later stage dementia, but what about the early to mid-stages when there are times of clarity?
I guess I'm putting myself in their place, which may not be a good way to judge. But I would feel patronized if I said something that wasn't so and no one told me, then later I had a moment when I realized it wasn't so. Not to mention it's really hard for me not to correct something my husband says that's inaccurate and it's hard for me not to ask him if he remembers a particular thing, especially since sometimes he does. And when he doesn't, I explain it to him, and he seems okay with it. Other times something comes up and he doesn't know what I'm talking about. An example is that he can't remember who some of our neighbors are, and when their names are mentioned, he questions it. I explain who they are and where they live. He never seems offended or upset when I do.
I tend to talk to him as the adult he is and not as if he's a particularly slow child, which is what rules 1 and 3 make me think of. Now, as things progress, those rules might apply more. And I could see those rules being applicable if the person with dementia got really upset when asked if they remember something or if they're corrected. My husband doesn't get upset, so I know I'm lucky in that respect.
I'd love to hear how others are handling the early and mid-stages with this.
Interested in more discussions like this? Go to the Caregivers: Dementia Support Group.
bclane I agree with you and how you don't understand asking direct questions. If we don't ask questions how are we suppose to know what they want? Because there are times of clarity (with my husband). If he seems confused about the question I'm asking, I will word it differently or maybe speak slower. When it comes to asking what he wants to drink or snack on, etc, I usually have to "show' him, and then it's a choice of 2 things and he looks more at ease with answering. This awful disease has been a struggle for both of us and I do everything I can to ease those struggles. There are times that the direct question I ask him, is if he knows my name and he looks confused, and more times than not, he will say 'umm no" and when I tell him he'll just say, OK and that's the end of that. I don't want to add to his confusion and remind him I'm his wife, but that's just me. Does it make me sad? Of course it does, but I know who I am and more importantly who HE is to me... my adorable, funny, handsome love of my life and will do everything I can for him!
Hugs and prayers to you
Counseling and/or support group can be so helpful. Our local council on aging has a lot of services for caregivers.
Reading these posts have both sympathy and admiration for all of you.
A home health aid comes once a week to give my husband a shower which is a necessity. I am not able to give him a shower and depend on her. He doesn't like to have a shower and gets all upset. She, the HHA, is amazing...she talks to him and goes ahead to the shower. He screams my name several times and I don't answer.
He is peaceful afterwards...this happens every week...I am thankful for her ability to do this for him.
I am dealing with this. I have found that I have to judge the situation. At times he responds normal like there is no problem and other times just the asking of any question or making a comment about anything, what's on tv, etc. sets him and ends up in a fight. I don't fight with him, I just go to my private room and let him stew. Or, as my daughter has told me, when he starts off on you leave, go for a ride, to the library etc. He may be in early dementia, but like Pavlo's dogs, he will learn that certain behaviors have certain outcomes. Don't know if she is right or not, but at least it gets me out of it.
I believe his big fear is being left alone, put into a home etc.
So far my husband has been okay with my reminding him we're married on the occasions he doesn't know who I am. Most of the time, he gives every indication of still knowing. I realize as the dementia progresses, that will probably change.
I'm sure it also depends on the personality of the person with dementia and the dynamic that existed between the caregiver and the person before dementia made its appearance. My husband has always been pretty easygoing, and he still is. The relationship was always on an equal footing, which isn't always the case with older couples. I would never have married a man who insisted on being the boss. I was a police officer for ten years, and you can't do that job by being subservient to males!
Anyway, now I think that previous dynamic helps because on the few occasions that my husband gets carried away about something or is insisting on doing something that could be potentially dangerous to him, I can tell him to knock it off or go to bed or whatever. When it's obvious that I've about had it, he listens and does what I tell him. I guess it's like dealing with a child in that respect. So far, that hasn't happened often, and it's a last resort when my stress level is about through the roof. Most of the time I can deal with him in a less bossy way. I really hope his personality stays like this because it's safer for him if he will do or not do what I tell him, but I know there's no guarantee of that. For all of us, it's just a day to day thing, I guess.
Most suggestions are offered with the best of intentions, and often based on having heard or read which strategies work best in communicating with your loved one with dementia. However, the person who is a 24/7 caregiver, knows which styles and approaches cause the least distress, and are the most effective. There are lots of commonalities of symptoms and quirks but every dementia sufferer has unique aspects as well. After being a constant caregiver for my wife the past 9 years, I take all suggestions with a grain of salt. Some are worth trying, but others I know for certain will do more harm than good. One suggestion I received numerous times from various sources, was "meet them where they are." Sounds wise and compassionate, right? Being empathic, I like the idea, and yet it is a questionable strategy in my opinion. In spite of how crazy life can get, we still have to function in a real world. Constantly correcting them does no good either. In our case, I find that it's easy to redirect conversations to her childhood years, or even the early years of our 61 year marriage. Bottom line is, you are approaching this intelligently and in a caring manner, and you may gently contradict sometimes, and at other times let it go. You decide. Trust yourself, would be my suggestion, but be open to creative ideas as well.
I have found that if my husband is in the mood of you don't do this or that..I asked him "how would you like me to handle this situation"? He says I don't know. Well then I can open the dialogue with simple questions. Like how well did you sleep? Are you hungry or craving something? It works ..but not always. Does anyone have a problem with your loved one saying " Stop screaming at me ? We have a 12 foot shower. It has been an echo chamber since we built the house. If you dispute him he says you always yell at me. Try whispering to a man that has hearing loss. We have 10 ft., 8 ft.and 12 ft. ceilings in various part of the house. He gets so angry ..so I speak as low as possible. Never works. So the conversation stops and I just let him think awhile. I come back and he says "I am sorry" Not always..but I will take what I can get Someday he is a young teenager and other times a school aged child. But when the adult come back he is mean and degrading. Once in awhile he is my nice and loving. Hugs to all
One thing I always tell myself., treat your spouse with respect. They have not asked to go through this unfortunate disease. (It's not easy with the constant questions on a conversation) Today he has tested my patience. Serenity Prayer!! The grate in the driveway broke after the FedEx truck made a delivery. Stuff happens.
My husband keeps obsessing on how we can fix this. I keep telling him I don't have an answer to his question.
Told him we will go tomorrow and get replacement grate. Everything is catastrophic in his mind.
SERENITY PRAYER!!!!
I noticed that with my husband, too. I guess it's because he used to be the one who took care of things that needed to be fixed around the house and property. He didn't necessarily fix them all himself, but he used to go nearly every morning to a restaurant where he'd have breakfast and coffee with other men, many of whom were retired. He would ask them about whatever it was that needed fixed and for the names of reliable repairmen. Now I take care of all that (without going to coffee and breakfast with the guys, of course!). I've learned that when there is a problem that needs taken care of, I'm better off not talking about it any more than I have to. I just get it taken care of, and he's never gotten upset about it.
Yes..my husband used to took care of everything around the house..I ask him to show me how to do this and that.. part of this journey.